TRICARE REGIONAL BREAKDOWNS BY STATE - CGM

1 TRICARE REGIONAL BREAKDOWNS BY STATE . WEST REGION. Contractor: TriWest Claims Processor: WPS. The West Region's network subcontractors include: Wisconsin Physicians Service Wisconsin Physicians Service (WPS) is TriWest's partner for claims processing. To receive claims processing information, please call 1-888-TRIWEST (1-888-874-9378). All claims are processed using current industry standards. Network providers are required to file claims electronically. All others are encouraged to file claims electronically but may file on paper. The West Region includes: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El Paso only), Utah, Washington, and Wyoming On July 1, 2004, TRICARE beneficiaries residing in the former Regions 9, 10, 12 and AK, which includes California, Alaska and Hawaii, became part of the new TRICARE West region.

2 TriWest Healthcare Alliance is the new REGIONAL contractor providing health care services and support in the TRICARE West region. * Includes Yuma, Ariz. Certain zip codes in St. Louis, MO and counties in Iowa assigned to the Rock Island Arsenal service area are not included in the TRICARE Central Region. 10/6/2004 Page 1 of 3. NORTH REGION. Contractor: Health Net Federal Services, Inc. (HNFS). Claims Processor: PGBA, LLC (Palmetto). Health Net Federal Services, Inc. is the new REGIONAL contractor providing health care services and support in the TRICARE North region. Health Net's TRICARE North Region office is located in Virginia, with corporate headquarters in California. The administration of the TRICARE contract is developed and maintained by Health Net. Health Net utilizes various partnerships for some services: Claims processing and claims customer service activities are provided and maintained by PGBA, LLC (PGBA). PGBA maintains , which offers many other helpful TRICARE services.

3 (PALMETTO). The North Region includes: Connecticut, Delaware, the District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin, and portions of Tennessee (Ft. Campbell area), Iowa (Rock Island Arsenal area), and Missouri (St. Louis area). On July 1, 2004, TRICARE beneficiaries residing in the former Regions 2 and 5 became part of the new TRICARE North region. On September 1, 2004, the former Region 1 (Northeast: Vermont, Rhode Island, Pennsylvania, New York, New Jersey, New Hampshire, Massachusetts, Maryland, Maine, the District of Columbia, Delaware, Connecticut, and Northern Virginia) also joined the new North region. 10/6/2004 Page 2 of 3. SOUTH REGION. Contractor: Humana-Military Claims Processor: PGBA, LLC (Palmetto). Welcome to the new TRICARE South Region! Humana-Military is the REGIONAL contractor providing health care services and support in the TRICARE .

4 South region. The South Region includes Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee (except the Fort Campbell area), and a major portion of Texas (except for the extreme southwestern El Paso area). On August 1, 2004, TRICARE beneficiaries residing in the former Region 3 and 4, which includes Florida, Georgia, South Carolina, Alabama, Mississippi, and Tennessee, became part of the new TRICARE South region. Humana Military's Network Subcontractors and Vendors PGBA, LLC (PGBA) is Humana Military's claims processing partner in the TRICARE South Region. PGBA is a fiscal intermediary for the military's TRICARE health benefits program. PGBA is one of the largest subsidiaries of BlueCross BlueShield of South Carolina. (PALMETTO). 10/6/2004 Page 3 of 3.